Commonly Used Drugs No Longer Covered
Here's a list of some drugs that are no longer covered as of January 1, 2021.3
If your prescription drug is on the list, you'll see other drug alternatives that may be options for you.
Find covered drug alternatives.
2021 Drug List
Here’s your 2021 drug list (for coverage that renews or starts on or after January 1, 2021):
$0 HDHP-HSA Preventive Drug List (This applies only for Blue Preferred Gold PPOSM 101, Blue Preferred Silver PPOSM 101, Blue Focus Gold POSSM 101 and Blue Focus Silver POSSM 101 plans)
- Some drugs may be covered under your health plan’s medical benefits instead of your pharmacy benefits.
- Drugs covered under your medical benefit must be given to you by a health care provider.
- If you are taking or prescribed a drug that is not on your plan’s drug list, call the number on your member ID card to see if the drug may be covered by your plan’s medical benefits.
You can save money by using an in-network pharmacy. Your out-of-pocket costs are often generally lower at an in-network pharmacy.
At a preferred pharmacy, you may pay the lowest copay or coinsurance.4 You may also fill up to a 90-day supply of most covered drugs in store or through home delivery.
To find all pharmacies in your 2021 network, visit myprime.com.
Please note, changes could be made to the pharmacies in the future.
If you use a drug manufacturer’s coupon or copay card to pay for a covered prescription drug, this amount will not apply to your plan deductible or out-of-pocket maximum.
Things to Do
Talk with your doctor about your next steps:
- Ask about lower-cost alternatives if your drug moves to a higher tier.
- Review other options if your drug is no longer covered (often a covered generic or brand alternative may be available).
- Have an authorization request sent to us, or change your prescription, if your drug has a new additional requirement.
- Order your prescriptions to be filled at in-network pharmacies.
Your doctor or pharmacist can answer questions or concerns you may have about your prescribed medications. Pharmacy selections and your care are always between you and your doctor.